https://scholars.lib.ntu.edu.tw/handle/123456789/474970
標題: | Effect of penicillin resistance on presentation and outcome of nonenterococcal streptococcal infective endocarditis | 作者: | RON-BIN HSU Lin F.-Y. |
關鍵字: | Embolization; Infective endocarditis; Penicillin resistance; Streptococcus | 公開日期: | 2006 | 卷: | 105 | 期: | 4 | 起(迄)頁: | 234-239 | 來源出版物: | Cardiology | 摘要: | Background and Aims: Most cases of infective endocarditis are caused by nonenterococcal streptococci. The emergence of strains resistant to penicillin is increasingly recognized worldwide. This study sought to assess the effect of penicillin resistance on presentation and outcome of streptococcal endocarditis. Methods: A retrospective study was conducted in a single tertiary care hospital. Results: Between August 1996 and December 2004, patients infected with nonenterococcal streptococcal endocarditis and known minimal inhibitory concentrations (MICs) to penicillin were included in this study. A total of 62 cases were identified: 48 (77%) cases of the streptococcal endocarditis were caused by viridans streptococci. The most common species groups identified were Streptococcus mitis in 12 (19%) cases, Streptococcus oralis in 9 (15%) cases, Streptococcus sanguis in 7 (11%) cases and Streptococcus mutans in 7 (11%) cases. There were 36 male and 26 female patients with a median age of 46 years (range: 1-85). Twenty-two patients (35%) had peripheral embolization and 10 patients (16%) died in hospital. Twenty-eight (45%) of the 62 patients were infected with streptococcal strains of MICs ?0.125 μg/ml to penicillin. Infection with streptococcal strains of MICs ?0.125 μg/ml to penicillin was associated with a lower incidence of all-site embolization, but was not associated with higher mortality or increased frequency of surgery. Conclusions: High-level penicillin resistance of the streptococci responsible for endocarditis was increasingly common and medical therapy with vancomycin had a good response. Penicillin resistance was associated with a decreased risk of embolization, but was not associated with higher mortality. Copyright ? 2006 S. Karger AG. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-33646537770&doi=10.1159%2f000091821&partnerID=40&md5=0fc01b56c7e7e43f09c67cd60b8e69a6 https://scholars.lib.ntu.edu.tw/handle/123456789/474970 |
ISSN: | 0008-6312 | DOI: | 10.1159/000091821 | SDG/關鍵字: | ceftriaxone; gentamicin; penicillin derivative; penicillin G sodium; vancomycin; adolescent; adult; aged; alpha hemolytic Streptococcus; article; bacterial endocarditis; child; clinical feature; controlled study; embolism; female; human; major clinical study; male; minimum inhibitory concentration; mortality; penicillin resistance; priority journal; retrospective study; Streptococcus agalactiae; Streptococcus bovis; Streptococcus infection; Streptococcus mitis; Streptococcus mutans; Streptococcus oralis; Streptococcus pneumoniae; Streptococcus sanguinis; tertiary health care; treatment outcome; Adolescent; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Child; Child, Preschool; Drug Resistance, Bacterial; Endocarditis, Bacterial; Female; Humans; Infant; Logistic Models; Male; Microbial Sensitivity Tests; Middle Aged; Penicillin Resistance; Pulmonary Embolism; Retrospective Studies; Risk Factors; Statistics, Nonparametric; Streptococcal Infections; Streptococcus mitis; Streptococcus mutans; Streptococcus oralis; Streptococcus sanguis; Treatment Outcome; Vancomycin |
顯示於: | 醫學系 |
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